06-1630 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:,
Application valuation:
Applicant:
06-00001630
77187 CASA.DEL SOL
77.3-360-016- -
POOL - RESIDENTIAL
MEDIUM DENSITY RES
40000
Architect or Engir
Tit!t 4 4 Qum&
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
------------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
Zreby affirm underpenaity of perjury that I am licensed under provisionsof.Chapter 9 (commencing with
hereby
of Division 3 Wthe Business and'Profes 'o Coda' and my License is in full force and effect.
License Class: C2:7 C53 Lf nse No.: 801
Z4rContract
OWNERIUILDER DEC ION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's. State License Law for the
following reason (Sec. 7031.5, Business and Professions Cade: Any city or county that requires -a permit to
construct, alter, improve, demolish, or repair- any' structure, prior Wits issuance, also requires the. applicantfor the
permit to fib a signed:statementthat.he or..she is licensed pursuant to the provisions of the Contractor's'.State
License Law (Chapter 9'(commencing with Section 7000) of Division 3 of the Business and Professions Code) or
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031:5 by
any.applicant fora permit subjects the applicaht to wcivil penalty.of not more than five hundred dollars (8500).:
(_) I, as owner of the property; or my employees with wages as their sole compensation,will do the work, and
the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The
Contractors' State License Law does nmapply to an owner of property who builds or improves thereon,
and who does the work himself or herself through his or her own employees, provided that the.
improvements are not intended or offered for sale. If, however, the building or'improvement is sold within
one year of completion, the owner -builder will have the burden of proving that he or she did not build or
improve for the purpose of sale.).
l _ 1 I, as owrier of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
property who:builds or improves thereon, and who contracts for the projects with a contractors) licensed
pursuant to the Contractors' State License'Law.).
(_ 1 I am exempt under. Sec. , B.AP.C: for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY .
1 hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name:_
Lender's Address:
L,QrEnT
Owner:
BIRDSELL
77-187 CASA DEL SOL
LA QUINTA, CA 92253
Contractor: .
VICTORIA LANDSCAPES/WATERFALL
82365 HIGHWAY 111, SUITE #104
INDIO., CA 9220.1
(760)775-0449
Lie. No.: 801813
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date.: 4/24/06
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following -declarations:
_ I have and will maintain mcertificate of consent to self -insure for workers',compensation, as provided
for..by Section 3700 of:the Labor Code, for the performance of the work for which this permit Is
issued:
I have and will maintain workers' compensationinsurance, ss required by Section of the Labor
Code, for thwperformance of the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier EVEREST NTNL Policy Number 380002849
I certify that, in the. performance of+the work for which this permit is issued, I shall not employ any
person in any manner somas to become rub- ect to the workers' compensation laws of'California,
and agree.that, if I sit become subje . the workers' compensation provisions of_Section.
3700 of the Lebo I shall forth cc ly with those provi
Date, (Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE UNLAWFUL,, AND SHALL
SUBJECT AN�EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS (8100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT ,Application is hereby made to the Director of Building and Safety for a, permit subjeotto the
conditions and restrictions setforth on this application.
1. Each person upon whose behalf this application is made, each person at whose requestand4or
whose benefit work is performed under or pursuant to any permit issued as a result of this.application,
the owner, and the applicant, each agrees to; and shall defend, indemnify and hold harmless the City
of La Quints, its officers, agents and employees for any actor omission related to the work being
performed under or following, issuance of, this permit.
2. Any permit issued as a result of this application becomes null and void if`work is notcommenoed
within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject
permit to cancellation.
I"certify that'I have read this application and state that the above information is'correct. I agree to comply with all
city and county ordinances and state laws relating to t r ing censtructio rebyauthorize r matives
of this yTc� nty to an ebove<mentio o for inspe ion
Djte: Z►ignature (Applicant or Agent).
Application Number . . . . . 06-00001630
Permit
. . . BLDG POOL PERMIT
Additional
desc .
Permit Fee
. . . . 349._50 Plan Check Fee
227.18
Issue Date
Valuation . . . .
40000
Expiration
Date 10/21/06
Qty Unit.Charge Per
Extension
BASE FEE
252.00
15.00
-------------------------------------------------------------------
6.5000 THOU BLDG 25,001-50,000
97.50
Permit
. . . MECH POOL
Additional
desc . .
Permit Fee
26.00 Plan Check Fee
6:5.0
Issue Date
. . . . Valuation . . . .
0
Expiration
Date 10/21/06
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00
11.0000 EA MECH FURNACE >10'0K
11.06
Permit
. . . ELEC POOL PERMIT -RES
Additional
desc .
Permit Fee
. . . . 45.00 Plan Check Fee
11.25
Issue Date
. . . Valuation . . .
0
Expiration
Date 10/21/06
Qty Unit Charge Per
Extension.
BASE FEE
15.00
1.0.0
30.0000 EA ELEC PRIVATE SWIMMING POOL
30.00
Permit
. . . PLUMBING
Additional
desc . .
Permit Fee
. . . 33.00 Plan Check Fee
8.25
Issue Date
. . . . Valuation
0
Expiration
Date 10/21/06
Qty Unit Charge Per
Extension
BASE FEE
15.00
2..00
6.0000 EA PLB FIXTURE
12.60
1.00
3.0000 EA PLB WATER INST/ALT/REP
3:00
1.00
3.0000 EA PLB GAS PIPE 1-4 OUTLETS
3.00
------------------ ---------------------------------------------
-- --------------------------------------------------------------Special Notes and Comments
Spe
POOL & SPA
ONLY. ALARMS/BARRIERS SHALL
Application Number . . . . . 06-00001630.
----------------------------------------------------------------------------
Special Notes and Comments
BE IN PLACE PRIOR TO PRE-PLASTER
INSPECTION. EQUIPMENT ENCLOSURE NOT
INCLUDED IN PERMIT.
Fee summary Charged Paid
------------------ ---------------------
Credited
----------
Due
Permit Fee Total 453.50 .00
r
.0.0
---------
453.50
Plan Check Total 253.18 .00
.00
253.1.8
Grand Total 706.68 .00 _
.00
706.68
, WPERMIT
Bin #
Cty, of La Wipta
Blinding B Safety Division
P.O. Box I SO4, 76-495 Cape Yampicw
La Quina, U 92253 - (760) 777-7012
Building Permit Application and `cracking Sheet
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APPLICANT: DO NOT WRITE BELOW THIS UNE
Submittal
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Reed
TRACXMG PERMIT FEES
Plan Sett
Plan C haL submitted
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Stroetutyt CAcs. ` '
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�fleirieirc`d;�t�ea�Y�roc cotssttions
�f �+ : Maa.Ci eck Deposie _ _ ,- -_ -. _
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lilted Caataet Pazo
,� plan Cheek Balance
$warty Cato:.
Ptah i kked up FAY ? 7S q o G 3
If /ZS Coasttoetiou
Flood plain plao
Pians resubmitted
Meebaaksl
Grading. platy
V Review. ready for eerrecdonsFusue
Eleetrieat.
Subeoetaetoe List
Called Contact Person
Irknabing
Cesot Deed
rPlaus pideed up
S.iti.l.
114-4. Approval
Plans resubmitted
Gradiug
IN HOUSE--
Review. ready for eorrec6voshssae
Developer impact Fee
Planning Approval
Called Coutaa Person
Pub. wks. Appy
Dace of pxtywit Issue
School Fees
Tetat'Pevesit Feel '
d £906 -51L -09L oul. M'8-1 Bla010ln d�0'£0 00 trZ AV